Phineas Gage and the Birth of Modern Neuroscience

On a September day in 1848, while working to lay a railroad bed in New England, Gage experienced what would become one of the most famous accidents in neuroscience.

During a routine blast, a tamping iron exploded upward, entering his left cheek, passing behind his left eye, and exiting the top of Gage's head. This iron rod, over three feet long, destroyed much of his left frontal lobe.

Despite the extent of the massive brain damage, Gage's survival was nothing short of miraculous. Treated by Dr. John Martyn Harlow, Gage recovered physically over the next few months, shocking many medical professionals of the time, including Henry Jacob Bigelow of Harvard Medical School.

Gage’s injury became a topic of debate at institutions like the Massachusetts Medical Society, where doctors analyzed the nature and effects of his trauma.

Gage's skull, along with the tamping iron, is now preserved at Harvard's Warren Anatomical Museum, an enduring symbol of frontal lobe damage and human resilience.

Perhaps the most discussed element of Gage's life is the reported personality change following the accident. The once diligent and reliable worker allegedly became "fitful, irreverent, and grossly profane" (Harlow's words), exhibiting impaired judgment, impulsivity and changes in social behavior.

According to Harlow, he was "no longer Gage". These behavioral changes highlighted the role of the prefrontal cortex, a region involved in decision-making, impulse control and social behavior.

The phrase "no longer Gage" is often cited in literature, reflecting how injuries to the frontal cortex may lead to transformations in a person's mental faculties and personality.

The Gage story significantly influenced 19th century theories about cerebral localization and factors determining personality. His injury lent weight to the idea that different brain regions — particularly the frontal lobe—controlled specific functions.

Modern researchers have used imaging technology and mapping connectivity damage to further analyze Gage's brain. Studies in environmental medicine and cognitive neuroscience often reference Gage to explore how localized damage can induce specific mental and behavioral shifts.

After leaving New England, Gage spent time in New Hampshire and eventually moved to Chile, where he worked as a stagecoach driver before moving to San Francisco to live with his family.

He reportedly regained some functionality, contradicting earlier claims that his decline was permanent. He died in 1860 after suffering epileptic seizures, likely tied to the original brain injury.

Gage's extraordinary story served as fodder for public imagination in surprising ways. His case was dramatized and mythologized, even displayed at Barnum's American Museum, and discussed by writers and researchers like Malcolm Macmillan, who wrote "Restoring Phineas Gage."

Gage's story has also appeared in exhibits like those at the Warren Museum.

The case continues to be taught in classrooms and appears in open access article distributed materials for psychology students. It's often referenced when discussing the challenges of restoring Phineas Gage, both physically and in terms of his social role.

His story supports our modern understanding of the human brain and remains an icon of resilience and transformation.

Today, Gage’s skull and iron bar remain among the most visited artifacts at Harvard University, symbolizing the link between brain injury and behavior. Even in death, Phineas Gage continues to teach us about mental faculties, frontal cortex function and the ongoing mysteries of the human brain.

We created this article in conjunction with AI technology, then made sure it was fact-checked and edited by a HowStuffWorks editor.